Repetition of Color Doppler Ultrasonography: Is it Necessary?

Akkuş, Emre; Alıcı, Bülent; Özkara, Hamdi; Ataus, Süleyman; Bagisgil, M.; Hattat, Halim

doi:10.1016/s0022-5347(01)62479-0

Cited by 9 publications

(14 citation statements)

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“…It was suggested that a repetition of ICI plus a PCDU test should be performed to avoid the influence of these physiological factors. 17 However, it was rarely accepted by the patients in clinics.…”

Section: Resultsmentioning

confidence: 99%

Pharmaco-induced erections for penile color-duplex ultrasound: oral PDE5 inhibitors or intracavernosal injection?

Yang

et al. 2012

Int J Impot Res

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To prospectively compare the clinical responses and penile color-duplex ultrasound (PCDU) results of oral PDE5 inhibitors (PDE5-Is) with papaverine intracavernosal injection (ICI) and to evaluate whether PDE5-Is could be used as alternatives to vasoactive agent injections, 25 ED patients underwent PCDU three times with an interval of at least 1 week, using different pharmacological induction: ICI mode (30--60 mg papaverine), sildenafil mode (100 mg sildenafil) and tadalafil mode (20 mg tadalafil). The preference of the patients was collected when all tests were completed. No significant differences were found in peak systolic velocity and acceleration time among all three modes. However for the ICI mode, end diastolic velocity of the right cavernosal artery was significantly higher than those of the sildenafil and tadalafil modes 5 min after erection induction, and at 15 min it became lower than those of two PDE5-I modes. Consequently, resistance index of the right cavernosal artery in ICI mode was reversed at 5 and 15 min. In all, 60.0 and 56.0% patients managed to reach full erection in PDE5-Is modes, which was significantly lower than in ICI mode (80.0%). Therefore, although PDE5-Is and papaverine ICI showed similar effects on PCDU parameters in detecting arterial ED, more patients had better clinical responses to ICI, and oral PDE5-Is administration still showed some pitfalls in practical use.

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Section: Resultsmentioning

confidence: 99%

Pharmaco-induced erections for penile color-duplex ultrasound: oral PDE5 inhibitors or intracavernosal injection?

Yang

et al. 2012

Int J Impot Res

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“…24 To determine arteriogenic ED, we performed two color Doppler tests, initially injecting PGE1 at the proposed dose of 10 mg 25 and subsequently doubling the dose to avoid falsely abnormal results, although repetition is not necessary in majority of the cases. 26 Thus, ED of the patients enrolled in this study was considered severe not only by the IIEF-5 score but because of the postinjection PSV as well.…”

Section: Discussionmentioning

confidence: 99%

A comparative, crossover study of the efficacy and safety of sildenafil and apomorphine in men with evidence of arteriogenic erectile dysfunction

et al. 2004

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The aim of the study was to establish and compare the efficacy and safety of sildenafil and apomorphine in men with arteriogenic erectile dysfunction (ED). In all, 43 men with ED and postinjection max penile systolic velocity o25 cm/s in repeated Doppler ultrasonography were included. Of these, 24 men started on apomorphine 2 mg and 19 on sildenafil 50 mg, the doses titrated up to 3 and 100 mg according to effectiveness and tolerability. Safety was evaluated according to adverse events (AEs) and patient withdrawal. Efficacy was the percentage of attempts resulting in erections firm enough for intercourse, based on event log data. The incidence of AEs with apomorphine 3 mg was higher than with sildenafil 100 mg. Two men on apomorphine 3 mg discontinued treatment due to AEs. The overall success rate of sildenafil was 63.7% compared to 32.1% of apomorphine (Pearson v 2 , Po0.01). Of all men, 25 (58.1%) responded to sildenafil 50 mg without the need for dose increase, while only one responded to apomorphine 2 mg. The response to sildenafil 50 mg was age related (analysis of variance, p¼0.04). Satisfaction was reported by 76.75 and 13.95% of patients for sildenafil and apomorphine, respectively, but 20.9% were not satisfied with any of the two drugs. In conclusion, this study provides clear evidence that sildenafil, even at 50 mg dose, is more effective than apomorphine 3 mg in men with arteriogenic ED. The fact that one out of five patients is not satisfied with the above-studied drugs shows that new oral agents need to be evaluated for the treatment of this disorder.

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“…After long-term treatment, in chronic erectile failure, PSV in cavernous arteries improved by some 34-35% after a mean period of 31-36 months of IC injections. 3,24 In 81-83% of patients' normal vascular values were found by DS after treatment compared to a normal cavernosal PSV found in 57-68% of patients before treatment. 25 Functional erections without injection were found in up to 54% of the patients, and no correlation was found between the total number of self-injections and PSV improvement.…”

Section: Introductionmentioning

confidence: 92%

“…25 Functional erections without injection were found in up to 54% of the patients, and no correlation was found between the total number of self-injections and PSV improvement. 3 However, in the above-mentioned studies, a clear relation between hemodynamic response and different etiologies has not been established. Sildenafil, a specific inhibitor of PDE5 in trabecular tissue, increases cGMP for some hours, sustaining smooth muscle relaxation.…”

Section: Introductionmentioning

confidence: 99%

“…DS can be therefore considered a reliable tool to measure PSV in penile arteries. 3 Arterial anatomical variations might modify the penile hemodynamic response and cavernous PSV in the medium and distal segments after intracavernous (IC) injection, affecting the results of DS in impotent patients. 4 In addition, different segments of arterial penile tree show a high variability of the measured PSV values, thus leading to an incorrect diagnosis in 21.8% of cases.…”

Section: Introductionmentioning

confidence: 99%

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Sildenafil citrate vs intracavernous alprostadil for patients with arteriogenic erectile dysfunction: a randomised placebo controlled study

et al. 2004

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We compared the effectiveness of sildenafil citrate and alprostadil in improving arterial penile inflow (peak systolic velocity (PSV)) and penile rigidity in 55 patients with erectile dysfunction caused by atherosclerosis. A total of 35 patients with pure vasculogenic impotency were randomly assigned to alprostadil (Av group; n¼11), sildenafil (Sv group; n¼12), or placebo (P group; n¼12), and 20 patients with nonvasculogenic impotency were randomly assigned to alprostadil (A group; n¼10) or Sildenafil (S group; n¼10): Av and A used alprostadil injection (capable of giving a full erection) once a week for 1 month, Sv and S took daily oral sildenafil (25 mg) for 1 month, and P took daily oral placebo for one month. The PSV was measured with Duplex sonography and penile rigidity was assessed using the IIEF-15 questionnaire, both of which were administered before and after treatment. Although both treatments improved penile rigidity, they increased PSV only in the Av and Sv groups. Our results suggest that alprostadil and oral therapy should be the starting therapy in men with vasculogenic impotency, whereas alprostadil should be avoided as the firstline approach in men with nonvasculogenic impotency.

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Repetition of Color Doppler Ultrasonography: Is it Necessary?

Cited by 9 publications

References 0 publications

Pharmaco-induced erections for penile color-duplex ultrasound: oral PDE5 inhibitors or intracavernosal injection?

Pharmaco-induced erections for penile color-duplex ultrasound: oral PDE5 inhibitors or intracavernosal injection?

A comparative, crossover study of the efficacy and safety of sildenafil and apomorphine in men with evidence of arteriogenic erectile dysfunction

Sildenafil citrate vs intracavernous alprostadil for patients with arteriogenic erectile dysfunction: a randomised placebo controlled study

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